Provider Demographics
NPI:1831448851
Name:PLUMB, KATHERINE (MA, MSW, ACSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PLUMB
Suffix:
Gender:F
Credentials:MA, MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 BEACH BLVD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:BUENA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90621-2840
Mailing Address - Country:US
Mailing Address - Phone:714-736-0231
Mailing Address - Fax:
Practice Address - Street 1:6301 BEACH BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:BUENA PARK
Practice Address - State:CA
Practice Address - Zip Code:90621-2840
Practice Address - Country:US
Practice Address - Phone:714-736-0231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program